摘要
目 的 探讨核磁共振成像 (magnetic resonance imaging,MRI)在 盆腔囊实性占位病变的诊断价值。方法 纳入我院2012年10月至2015年12月所收 治的100例盆腔占位病变女性患者作为研 究对象,均行MRI检查方法并经手术病理 证实,分析不同性质占位病变患者的MRI 影像表现及良恶性病变的鉴别要点。结 果 100例患者中,65例为囊性占位病变, 包括21例卵巢囊腺瘤、14例卵巢囊腺癌、 12例卵巢子宫内膜异位囊肿、10例卵巢囊 肿、8例盆腔脓肿;35例为囊实性占位病 变,包括20例卵巢畸胎瘤、15例卵巢癌。 盆腔良性占位病变以囊性占位居多,边界 清晰,信号均匀、囊壁薄并均匀,增强一 般无强化征象;恶性占位病变以囊实性混 合肿块居多,形态不规则、累及范围广, 囊壁厚薄不均,并可见附壁结节,T1WI、 T2WI呈混杂信号,增强后囊壁及壁结节可 见不同程度强化。结论 MRI具有多轴向成 像、软组织分辨率高等优点,可利用其丰 富成像序列、动态增强扫描对盆腔占位病 变的囊实性及其来源进行判断,并进行良 恶性鉴别,在诊断女性盆腔占位病变中具 有较高应用价值。
Objective To retrospectively analyze the value of MRI in the diagnosis of 100 cases with pelvic cystic and solid space occupying lesions. Methods One hundred cases of female patients with pelvic occupying lesions who were treated in our hospital from October 2012 to December 2015 were analyzed retrospectively. All patients underwent MRI examination. The MRI findings of patients with different kinds of occupying lesions and the key points in the differential diagnosis of benign and malignant lesions were analyzed. Results Among the 100 patients, there were 65 cases with cystic occupying lesions, including 21 cases with ovarian cystadenoma, 14 cases with ovarian cystadenocarcinoma, 12 cases with ovarian endometriosis cysts, 10 cases with ovarian cysts, 8 cases with pelvic abscess. There were 35 cases with cystic and solid occupying lesions, including 20 cases with ovarian teratoma, 15 cases with ovarian cancer. Pelvic benign placeholder lesions were mainly cystic lesions with clear boundary, uniform signal, thin and uniform cystic wall, no enhancement; Malignant lesions were mainly cystic or solid mixed mass with irregular shape, wide range of involvement, cystic wall of uneven thickness, and visible wall nodule. The lesions showed mixed signal in T1WI and T2WI. The cystic wall and wall nodule had different degrees of reinforcement after enhanced scan. Conclusion The application of MRI in pelvic cystic and solid occupying lesions has such advantage as multi-axial imaging, high resolution of soft tissues etc.. Rich imaging sequences, dynamic enhanced scanning can be applied in differential diagnosis of cystic and solid lesions, and the differential diagnosis of benign and malignant lesions. It is of great application value on female patients with pelvic occupying lesions.
【关键词】盆腔;占位病变;囊实性
【中图分类号】R445.2;R737.31
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.07.030
前言
盆腔占位病变为妇产科常见病,目前以超声为首选检查方法。核 磁共振成像为目前影像学研究与发展重要方向,具有多平面、多方 位、多参数、软组织高分辨率与对比度等优点[1],且无需改变体位, 无辐射损伤成像,可充分显示病变范围及与邻近组织、器官关系,定 位、定性诊断效果佳,为最敏感断面成像技术,对女性盆腔占位病变 的显示有较大优越性。本研究以我院2012年10月~2015年12月所收治 100例盆腔占位病变女性患者为例展开回顾性分析,探析MRI检查在盆 腔囊实性占位病变诊断及良恶性鉴别中应用价值,现报道如下。
中国CT和MRI杂志
第14卷, 第 7 期
2016年07月
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